Abstract
Lateral wedge insoles have consistently shown to reduce the external knee adduction moment (EKAM) in medial knee osteoarthritis (OA) patients; although there is evidence that certain patients have a paradoxical increase in EKAM. This may be a key factor in determining clinical response and thus identifying and understanding why these patients increase EKAM is critical for prescribing the correct treatment for these patients. Previous evidence has suggested that foot and ankle biomechanics play a role in reducing EKAM by shifting the centre of foot pressure (COFP) laterally and increasing the valgus orientation of the calcaneus, which shortens the lever arm in respect of the knee, thus reducing the EKAM. To date, patients have been studied irrespective of biomechanical response to lateral wedge insoles. In this study we investigated whether dynamic ankle biomechanics can assist in identifying and explaining why some patients increase EKAM and other decrease EKAM when wearing a lateral wedge.
Highlights
Lateral wedge insoles have consistently shown to reduce the external knee adduction moment (EKAM) in medial knee osteoarthritis (OA) patients; there is evidence that certain patients have a paradoxical increase in EKAM
Of the 70 participants studied (43 male), 20% increased their EKAM and 54% decreased their EKAM. Both pairs of lateral wedge insoles caused the foot to be in a significantly more everted position compared to the control condition with one insole greater
Individuals with a higher peak ankle eversion angle or a higher eversion angle at peak EKAM during the control condition were more likely to classified as a biomechanical responder to the lateral wedges
Summary
Foot and ankle biomechanics play a role in biomechanical response to lateral wedge insoles. Richard K Jones1*, Graham J Chapman, Matthew J Parkes, Laura Forsythe, David T Felson. From 4th Congress of the International Foot and Ankle Biomechanics (i-FAB) Community Busan, Korea. From 4th Congress of the International Foot and Ankle Biomechanics (i-FAB) Community Busan, Korea. 8-11 April 2014
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